Evidence map›Paper›PMID 33227427›Full record

ArticleAnaerobe2021

Anti-toxin antibody is not associated with recurrent Clostridium difficile infection.

Julie Gilbert, Jhansi Leslie, Rose Putler, Shayna Weiner, Alexandra Standke, Aline Penkevich, Micah Keidan, Vincent B Young, Krishna Rao

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Anaerobe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.1field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Novel Biomarkers, IncludingInfection and immunity · 2023
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Julie GilbertSchool of Public Health, USA.
Jhansi LeslieDepartment of Microbiology and Immunology, USA.
Rose PutlerDepartment of Microbiology and Immunology, USA.
Shayna WeinerDepartment of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
Alexandra StandkeDepartment of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
Aline PenkevichDepartment of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
Micah KeidanDepartment of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
Vincent B YoungDepartment of Microbiology and Immunology, USA; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA.
Krishna RaoDepartment of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, MI, USA. Electronic address: krirao@med.umich.edu.
University of Michigan · US

Funding

Systems biology of Clostridium difficile infectionU01AI124255 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SCHLOSS, PATRICK DAVID, YOUNG, VINCENT B · 2016 to 2020
$9.8M
Host and Microbial Biomarkers Related to the Development of Complicated Clostridium difficile InfectionR21AI120599 · NIAID · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI YOUNG, VINCENT B · 2015 to 2016
$426k
NIAID NIH HHS R21 AI120599NIAID NIH HHS U01 AI124255
6 · The paper itself

Abstract

Clostridium difficile infection (CDI) recurs in ∼20% of patients. Prior studies indicated that antibody responses directed against the C. difficile toxins A and B were potentially associated with lower risk of recurrent CDI. Here we tested the hypothesis that circulating anti-toxin IgG antibody levels associate with reduced risk of recurrent CDI. A cohort study with prospective enrollment and retrospective data abstraction examined antibody levels in 275 adult patients at the University of Michigan with CDI. We developed an enzyme linked immunosorbent assay to detect IgG antibodies against toxin A and toxin B in sera obtained at the time of diagnosis. Logistic regression examined the relationship between antibody levels and recurrence, and sensitivity tests evaluated for follow-up and survivor biases, history of CDI, and PCR ribotype. Follow-up data were available for 174 subjects, of whom 36 (20.7%) had recurrence. Comparing antibody levels vs. recurrence and CDI history, anti-toxin A levels were similar, while anti-toxin B levels had a greater range of values. In unadjusted analysis, detection of anti-toxin A antibodies, but not anti-toxin B antibodies, associated with an increased risk of recurrence (OR 2.71 [1.06, 8.37], P = .053). Adjusting for confounders weakened this association. The results were the same in sensitivity analyses. We observed a borderline increased risk of recurrence in patients positive for anti-toxin A antibodies, and sensitivity analyses showed this was not simply a reflection of prior exposure status. Future studies are needed to assess how neutralizing antibody or levels after treatment associate with recurrence.

Indexed as

AdultAgedAntibodies, BacterialAntibodies, NeutralizingBacterial ProteinsBacterial ToxinsClostridioides difficileClostridium InfectionsEnzyme-Linked Immunosorbent AssayFemaleHumansImmunoglobulin GLogistic ModelsMaleMiddle AgedPolymerase Chain ReactionAntibodies, BacterialAntibodies, NeutralizingBacterial ProteinsBacterial ToxinsImmunoglobulin GAntibodiesBacterial toxinsClostridium difficileHealthcare-associated infections

Identifiers

PMID33227427
PMCPMC8094835
OpenAlexW3108667464

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.